Dosunmu Shekinah D, Sarno Albert, Lee Eunice, Mitchell Cassandra, Wang Julia, Shaak Kyle
Lehigh Valley Health Network, Allentown, USA.
Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, USA.
Abdom Radiol (NY). 2025 Jun 14. doi: 10.1007/s00261-025-05039-y.
OBJECTIVE(S): This study aims to assess the diagnostic accuracy of the revised Morphologic Uterus Sonographic Assessment (MUSA) criteria for adenomyosis.
Retrospective review on 96 patients who underwent hysterectomy following ultrasound assessment between 1/3/2020-11/30/2023 for clinical reasons. Two blinded physician reviewers independently evaluated ultrasound images using the modified MUSA criteria. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and interrater reliability of the modified MUSA criteria were determined using hysterectomy specimens as the reference gold standard.
Reviewer 1 found the modified MUSA criteria were found to have a sensitivity of 63.2%, specificity of 65.5%, PPV of 54.4%, and NPV of 73.1%. For reviewer 2, sensitivity was 42.1%, specificity 62.1%, PPV 42.1%, and NPV 62.1%. Interrater agreement using Cohen's kappa was 72.9%.
CONCLUSION(S): The modified MUSA criteria demonstrate moderate sensitivity and specificity in diagnosing adenomyosis. Inter-rater agreement was moderate with 72.9% concordance between ultrasound examiners. While useful in clinical assessment, this study suggests that the modified MUSA criteria lack high specificity and sensitivity, limiting their standalone diagnostic reliability.
本研究旨在评估修订后的子宫形态超声评估（MUSA）标准对子宫腺肌病的诊断准确性。
对2020年1月3日至2023年11月30日期间因临床原因在超声评估后接受子宫切除术的96例患者进行回顾性研究。两名盲法医师审阅者使用改良的MUSA标准独立评估超声图像。以子宫切除标本作为参考金标准，确定改良MUSA标准的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以及审阅者间的可靠性。
审阅者1发现改良的MUSA标准的敏感性为63.2%，特异性为65.5%，PPV为54.4%，NPV为73.1%。对于审阅者2，敏感性为42.1%，特异性为62.1%，PPV为42.1%，NPV为62.1%。使用Cohen's kappa的审阅者间一致性为72.9%。
改良的MUSA标准在诊断子宫腺肌病方面表现出中等的敏感性和特异性。超声检查者之间的审阅者间一致性为中等，一致性为72.9%。虽然在临床评估中有用，但本研究表明改良的MUSA标准缺乏高特异性和敏感性，限制了它们的独立诊断可靠性。
